REVIEW – March 2018

Diagnostics and management of chronic migraine

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Chronic migraine occurs in about 8% of all migraine patients. Annually, episodic migraine transforms to chronic migraine in 2.5% of the patients. Special attention should be paid to patients who have 10–14 attacks per month (high frequency episodic migraine, HFEM),who comprise a high-risk group for migraine cronification. There are also several other risk factors that promote the transition from episodic migraine to chronic migraine, the most remarkable being the overuse of analgesic medications. The pathophysiology of transformation from episodic to chronic migraine is poorly understood. Treatment target includes prevention of chronification of episodic migraine and reversal from the chronic to the episodic profile of the disease. Timely prescribed preventive medications and multimodal migraine treatment programmes, including non-pharmacologic options, are of importance.